李慧锋;黄悦;李红娟;郑凤仙;李彩红;朱孔鑫;黄兴成;胡潇文;苏迎盈;

• 1:新密市妇幼保健院
• 2:厦门大学公共卫生学院国家传染病诊断试剂与疫苗工程技术研究中心分子疫苗学和分子诊断学国家重点实验室医用生物制品省部共建协同创新中心

摘要(Abstract)：

本研究旨在分析中国河南省新密市孕妇巨细胞病毒（Cytomegalovirus, CMV）血清流行特征，及新生儿先天性CMV(CCMV)感染特征，为将来CCMV感染预防奠定基础。2015年至2017年，河南省新密市妇幼保健院开展了一项前瞻性队列研究，对于孕早期在本院进行建卡产检的孕妇连续招募入组，分别在孕早期、孕中期及孕晚期采集其血液标本进行CMV-IgG检测。孕妇分娩后，采集新生儿唾液和尿液标本开展CMV-DNA检测，进行CCMV筛查和确认性检测。新密市孕妇CMV抗体阳性率为97.80%(3594/3 675,95%CI:97.27%～98.25%)，人群抗体阳性率、抗CMV～IgG抗体水平均随年龄有上升趋势。在抗体阳性孕妇中，孕早期IgG几何平均抗体浓度为11.10IU/mL(95%CI:10.80 IU/mL～11.41 IU/mL)；在抗体阴性孕妇中，孕期抗体阳转率为11.39%(9/79,95%CI:4.39%～18.40%)。新密市CCMV估算感染率为1.33%(49.28/3694,95%CI:1.01%～1.76%),97.92%CCMV新生儿来自孕早期抗体阳性孕妇。河南省新密市孕妇CMV抗体阳性率极高，新生儿CCMV感染率也较高。CMV抗体阳性率与抗体水平均随着孕妇年龄有上升趋势。

关键词(KeyWords)： 巨细胞病毒;先天性感染;流行病学;抗体

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金（项目号：81973058）,题目：抗体阳性孕妇中巨细胞病毒垂直传播及相关不良临床结局危险因素研究~~

作者(Authors): 李慧锋;黄悦;李红娟;郑凤仙;李彩红;朱孔鑫;黄兴成;胡潇文;苏迎盈;

DOI: 10.13242/j.cnki.bingduxuebao.004258

参考文献(References)：

• [1] Zuhair M, Smit GSA, Wallis G, Jabbar F, Smith C,Devleesschauwer B, Griffiths P:Estimation of the worldwide seroprevalence of cytomegalovirus:A systematic review and meta-analysis[J/OL]. Rev Med Virol, 2019, 29(3):e2034. DOI:10.1002/rmv.2034.
• [2] Compans RW, Cooper MD, Honjo T, Koprowski H,Melchers F, Oldstone MBA, Olsnes S, Vogt PK:Human cytomegalovirus[M]. Springer-Verlag Berlin Heidelberg; 2008.
• [3] El Baba R, Herbein G:Immune landscape of CMV infection in cancer patients:from"canonical"diseases toward virus-elicited oncomodulation[J/OL]. Front Immunol, 2021, 12:730765. DOI:10.3389/fimmu.2021.730765.
• [4] Huang Y, Song Q, Guo X, Wang H, Shen H, Wu T,Fu T-M, Zhang J:Risk factors associated with the vertical transmission of cytomegalovirus in seropositive pregnant women[J/OL]. Future Virology, 2019, 14(4):265-273. DOI:10.2217/fvl-2018-0183.
• [5] Manicklal S, Emery VC, Lazzarotto T, Boppana SB,Gupta RK:The"silent"global burden of congenital cytomegalovirus[J/OL]. Clin Microbiol Rev, 2013, 26(1):86-102. DOI:10.1128/CMR.00062-12.
• [6] Giannattasio A, Di Costanzo P, De Matteis A, Milite P, De Martino D, Bucci L, Augurio MR, Bravaccio C,Ferrara T, Capasso L, Raimondi F:Outcomes of congenital cytomegalovirus disease following maternal primary and non-primary infection[J/OL]. J Clin Virol,2017, 96:32-36. DOI:10.1016/j.jcv.2017.09.006.
• [7] Townsend CL, Forsgren M, Ahlfors K, Ivarsson SA,Tookey PA, Peckham CS:Long-term outcomes of congenital cytomegalovirus infection in Sweden and the United Kingdom[J/OL]. Clin Infect Dis, 2013, 56(9):1232-1239. DOI:10.1093/cid/cit018.
• [8] de Vries JJ, van Zwet EW, Dekker FW, Kroes AC,Verkerk PH, Vossen AC:The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection:a population-based prediction model[J/OL]. Rev Med Virol, 2013, 23(4):241-249.DOI:10.1002/rmv.1744.
• [9] Goderis J, De Leenheer E, Smets K, Van Hoecke H,Keymeulen A, Dhooge I:Hearing loss and congenital CMV infection:a systematic review[J/OL].Pediatrics, 2014, 134(5):972-982. DOI:10.1542/peds.2014-1173.
• [10]Rawlinson WD, Boppana SB, Fowler KB, Kimberlin DW, Lazzarotto T, Alain S, Daly K, Doutre S,Gibson L, Giles ML, Greenlee J, Hamilton ST,Harrison GJ, Hui L, Jones CA, Palasanthiran P,Schleiss MR, Shand AW, van Zuylen WJ:Congenital cytomegalovirus infection in pregnancy and the neonate:consensus recommendations for prevention, diagnosis,and therapy[J/OL]. Lancet Infect Dis, 2017, 17(6):e177-e188. DOI:10.1016/S1473-3099(17)30143-3.
• [11]Huang X, Li JJ, Ge SX, Li TD, Wang H, Guo XY,Fu TM, Zhagn J:Establishment and validation of an enzyme-linked immunosorbent assay for IgG antibody against cytomegalovirus based on pp150 antigen[J/OL]. J Virol Methods, 2017, 240:21-25. DOI:10.1016/j.jviromet.2016.11.001.
• [12]Huang Y, Tang J, Wang H, Yu H, Song Q, Guo X,Li C, Wang J, Liang C, Li S, Li S, Lin Z, Chen Q,Zhong G, Zhuang S, Su Y, Li T, Wu T, Ge S, Zhang J, Xia N:Pre-existing maternal IgG antibodies as a protective factor against congenital cytomegalovirus infection:A mother-child prospective cohort study[J/OL]. eBioMedicine, 2022, 77:103885. DOI:10.1016/j.ebiom.2022.103885.
• [13]Huang Y, Wang H, Li T, Li C, Tang J, Yu H, Guo X, Song Q, Wei F, Wang J, Liang C, Zheng F, Li H,Li H, Wu H, Lu Z, Su Y, Wu T, Ge S, Fu T-M,Zhang J, Xia N:Comparison of detection strategies for screening and confirming congenital cytomegalovirus infection in newborns in a highly seroprevalent population:a mother-child cohort study[J/OL]. Lancet Reg Health Western Pac, 2021, 12:100182. DOI:10.1016/j.lanwpc.2021.100182.
• [14]Huang Y, Li T, Yu H, Tang J, Song Q, Guo X,Wang H, Li C, Wang J, Liang C, Yao X, Qiu L,Zhuang C, Bi Z, Su Y, Wu T, Ge S, Zhang J:Maternal CMV seroprevalence rate in early gestation and congenital cytomegalovirus infection in a Chinese population[J/OL]. Emerg Microbes Infect, 2021, 10(1):1824-1831. DOI:10.1080/22221751.2021.1969290.
• [15]Li TD, Li JJ, Huang X, Wang H, Guo XY, Ge SX,Zhang J:Baseline antibody level may help predict the risk of active human cytomegalovirus infection in a HCMV seropositive population[J/OL]. Eur J Clin Microbiol Infect Dis, 2016, 5(36):863-868. DOI:10.1007/s10096-016-2873-8.
• [16]Jin Q, Su J, Wu S:Cytomegalovirus infection among pregnant women in Beijing:seroepidemiological survey and intrauterine transmissions[J/OL]. J Microbiol Biotechnol, 2017, 27(5):1005-1009. DOI:10.4014/jmb.1612.12020.
• [17]喻欢，黄悦，卫飞雪，宋巧巧，苏迎盈，吴婷：新生儿先天性巨细胞病毒感染的研究进展[J].中国妇幼保健，2018, 33(14):3345-3349.
• [18]Huang Y, Guo X, Song Q, Wang H, Yu H, Zhang Y,Qiao E, Xue W, Li X, Zhuang S, Wei F, Li T, Ge S,Wu T, Xia N, Zhang J:Cytomegalovirus shedding in healthy seropositive female college students:A 6-month longitudinal study[J/OL]. J Infect Dis, 2018, 217(7):1069-1073. DOI:10.1093/infdis/jix679.
• [19]Jergovi?M, Contreras NA, Nikolich-?ugich J:Impact of CMV upon immune aging:facts and fiction[J/OL].Med Microbiol Immunol, 2019, 208(3-4):263-269.DOI:10.1007/s00430-019-00605-w.
• [20]Sansoni P, Vescovini R, Fagnoni FF, Akbar A, Arens R, Chiu YL, Ci?in-?ain L, Dechanet-Merville J,Derhovanessian E, Ferrando-Martinez S, Franceschi C,Frasca D, Ful?p T, Furman D, Gkrania-Klotsas E,Goodrum F, Grubeck-Loebenstein B, Hurme M, Kern F, Lilleri D, López-Botet M, Maier AB, Marandu T,Marchant A, Mathe?C, Moss P, Muntasell A,Remmerswaal EB, Riddell NE, Rothe K, Sauce D,Shin EC, Simanek AM, Smithey MJ, S?derbergNauclér C, Solana R, Thomas PG, van Lier R,Pawelec G, Nikolich-Zugich J:New advances in CMV and immunosenescence[J/OL]. Exp Gerontol, 2014,55:54-62. DOI:10.1016/j.exger.2014.03.020.
• [21]Zhang XW, Li F, Yu XW, Shi XW, Shi J, Zhang JP:Physical and intellectual development in children with asymptomatic congenital cytomegalovirus infection:a longitudinal cohort study in Qinba mountain area, China[J/OL]. J Clin Virol, 2007, 40(3):180-185. DOI:10.1016/j.jcv.2007.08.018.
• [22]Wang S, Wang T, Zhang W, Liu X, Wang X, Wang H, He X, Zhang S, Xu S, Yu Y, Jia X, Wang M, Xu A, Ma W, Amin MM, Bialek SR, Dollard SC, Wang C:Cohort study on maternal cytomegalovirus seroprevalence and prevalence and clinical manifestations of congenital infection in China[J/OL]. Medicine(Baltimore), 2017, 96(5):e6007. DOI:10.1097/md.0000000000006007.
• [23]北京地区母婴巨细胞病毒感染课题组，李莉，米荣，李铁耕，徐放生，赵林清，李扬，张素云，黄醒华，李洋远，李智，张运平，刘晓红，卢新，张雪峰，周俊杰，刘亚非，崔惠英，吕志兰：北京地区新生儿先天巨细胞病毒感染状况研究[J].中国新生儿科杂志，2012(01):5-9.
• [24]北京地区母婴巨细胞病毒感染课题组，李莉，米荣，李铁耕，徐放生，赵林清，李扬，张素云，黄醒华，李洋远：北京地区新生儿先天巨细胞病毒感染状况研究[J].中华新生儿科杂志，2012, 27(1):5-9.
• [25]Putri ND, Wiyatno A, Dhenni R, Sriyani IY,Dewantari AK, Handryastuti S, Iskandar ATP, Rahma MM, Jumiyanti N, Aprilia YY, Prayitno A, Karyanti MR, Satari HI, Hadinegoro SR, Myint KSA, Safari D:Birth prevalence and characteristics of congenital cytomegalovirus infection in an urban birth cohort,Jakarta, Indonesia[J/OL]. Int J Infect Dis, 2019, 86:31-39. DOI:10.1016/j.ijid.2019.06.009.